New UNAIDS report shows AIDS epidemic has been halted and world beginning to reverse the spread of HIV. New HIV infections have fallen by nearly 20% in the last 10 years, AIDS-related deaths are down by nearly 20% in the last five years, and the total number of people living with HIV is stabilizing.

GENEVA, 23 November 2010—A new report by the Joint United Nations Programme on HIV/AIDS (UNAIDS), released today, shows that the AIDS epidemic is beginning to change course as the number of people newly infected with HIV is declining and AIDS-related deaths are decreasing. Together, this is contributing to the stabilization of the total number of people living with HIV in the world.

Data from the 2010 UNAIDS Report on the global AIDS epidemic shows that an estimated 2.6 million  [2.3 million–2.8 million] people became newly infected with HIV, nearly 20% fewer than the 3.1 million  [2.9 million–3.4 million] people infected in 1999.

In 2009, 1.8 million [1.6 million–2.1 million] people died from AIDS-related illnesses, nearly one-fifth lower than the 2.1 million [1.9 million–2.3 million] people who died in 2004. 

At the end of 2009, 33.3 million [31.4 million–35.3 million] people were estimated to be living with HIV, up slightly from 32.8 million[1] [30.9 million–34.7 million] in 2008. This is in large part due to more people living longer as access to antiretroviral therapy increases.

 “We are breaking the trajectory of the AIDS epidemic with bold actions and smart choices,” said Mr Michel Sidibé, Executive Director of UNAIDS. “Investments in the AIDS response are paying off, but gains are fragile—the challenge now is how we can all work to accelerate progress.”

Prevention is working

The 2010 report contains basic HIV data from 182 countries and includes country-by-country scorecards. The report gives new evidence that investments in HIV prevention programming are producing significant results in many of the highest burden countries.

From 2001 to 2009, the rate of new HIV infections stabilized or decreased by more than 25% in at least 56 countries[2] around the world, including 34 countries in sub-Saharan Africa. Of the five countries with the largest epidemics in the region, four countries—Ethiopia, South Africa, Zambia and Zimbabwe—have reduced rates of new HIV infections by more than 25%, while Nigeria’s epidemic has stabilized.

Sub-Saharan Africa continues to be the region most affected by the epidemic with 69% of all new HIV infections. In seven countries, mostly in Eastern Europe and Central Asia, new HIV infection rates have increased by 25%.

Among young people in 15 of the most severely affected countries, the rate of new HIV infections has fallen by more than 25%, led by young people adopting safer sexual practices. In South Africa, the rate of new HIV infections among 18-year-olds declined sharply from 1.8% in 2005 to 0.8% in 2008 and among women 15–24 years-old it dropped from 5.5% to 2.2% between 2003 and 2008.

In 59 countries including 18 of the 25 countries with the highest HIV prevalence, less than 25% of men reported having sex with more than one partner in the last 12 months. Eighty-four countries reported the same behaviour trends for women.

Condom use and availability have increased significantly. Eleven countries—from Burkina Faso, to India, and Peru—report more than 75% condom use at last higher-risk sex. Data from 78 countries show that condom use among men who have sex with men was more than 50% in 54 countries. Reports of condom use by sex workers are also encouraging. In 69 countries, more than 60% of sex workers used a condom with their last client.

Access to HIV prevention services including harm reduction programmes for people who inject drugs has reached 32%—far short of what is needed to protect drug users from HIV worldwide. Even though many countries have included male circumcision in their prevention programmes, uptake at a population level remains low, and has not made a significant impact on the rate of new HIV infections.

New HIV infections slowing but still outpace treatment success by 2:1

Even though the number of new HIV infections is decreasing, there are two new HIV infections for every one person starting HIV treatment.

Investments in HIV prevention programmes as whole have not been adequate or efficiently allocated. HIV prevention investments comprise about 22% of all AIDS-related spending in low- and middle-income countries.

Declines in AIDS-related deaths

More people are living longer and AIDS-related deaths are declining as access to treatment has expanded. The total number of people on treatment increased by seven and half times over the last five years with 5.2 million people accessing life-saving drugs in 2009, compared to 700 000 in 2004. Over the course of the last year alone, an additional 1.2 million people received treatment—a 30% increase compared to 2008. In addition, there has been a secondary dividend of stopping new HIV infections with increased access to HIV treatment.

However, nearly twice the number of people—10 million—are waiting for treatment. New evidence shows that scaling up treatment has led to reductions in population mortality in high-prevalence settings. The results could be better—most people receiving antiretroviral therapy in sub-Saharan Africa start treatment late, which limits the overall impact of HIV treatment programmes. Countries have made slow but good progress in integrating tuberculosis and HIV programmes.

Significant progress in the virtual elimination of HIV to babies—handful of countries hold key to success

As more countries are using effective treatment regimens to prevent HIV transmission to babies, the total number of children born with HIV has decreased. An estimated 370 000 [230 000–510 000] children were newly infected with HIV in 2009, representing a drop of 24% from five years earlier.

Significant gains were observed in sub-Saharan Africa where new HIV infections among children have fallen 32%.

Just 14 countries now account for more than 80% of the gap in providing services to prevent mother-to-child transmission. Nigeria alone contributes to 32% of the worldwide gap.

Human rights are part of AIDS strategies but not fully implemented

The report also contains new data which shows that human rights efforts are increasingly being integrated into national AIDS strategies, with 89% of countries explicitly acknowledging or addressing human rights in their AIDS strategies and 91% having programmes in place to reduce stigma and discrimination. However, punitive laws continue to hamper access to AIDS-related services—79 countries worldwide criminalize same sex relations and six apply the death penalty. In the Asia-Pacific region, 90% of countries have laws which obstruct the rights of people living with HIV.

Resource demand outstripping supply

UNAIDS estimates that a total of US$ 15.9 billion was available for the AIDS response in 2009, US$ 10 billion short of what is needed in 2010 and funding from international sources appears to be reducing. Donor governments’ disbursements for the AIDS response in 2009 stood at US$ 7.6 billion, lower than the US$ 7.7 billion available in 2008. Declines in international investments will affect low-income countries the most—nearly 90% rely on international funding for their AIDS programmes.

The report highlights the urgent need to sustain and scale up good investments and for countries to share the financial burden of the epidemic. Many countries are under-investing and need to increase their domestic financial commitments to sustain and scale up the AIDS response. A new Domestic Investment Priority Index developed by UNAIDS shows that almost half of the 30 countries in sub-Saharan Africa are spending less than their capacity— commensurate to their disease burden and availability of government resources. The index also shows that some developing countries with strong economies can meet a substantial portion of their resource needs from domestic sources alone.

[1] The 2008 estimate for the number of people living with HIV was revised to 32.8 million [30.9 million–34.7 million] within the range of the previous estimate. The revision was based on new data from countries, including data from population-based surveys such as in Mozambique.

[2] A total of 63 countries were studied. For some countries with complex epidemics including multiple population groups with different risk behaviours as well as major geographic differences, such as Brazil, China and the Russian Federation, this type of assessment is highly complex and could not be concluded in the 2010 HIV estimation analysis.

GENEVA, 20 November 2010—UNAIDS welcomes the reported statement of Pope Benedict XVI calling for “a humane way of living sexuality” and that the use of condoms are justified "in the intention of reducing the risk of HIV infection".

“This is a significant and positive step forward taken by the Vatican today,” said UNAIDS Executive Director Michel Sidibé. “This move recognizes that responsible sexual behaviour and the use of condoms have important roles in HIV prevention.” 

UNAIDS has worked closely with the Vatican, in 2009 Mr Sidibé held far-reaching discussions with Archbishop Zygmunt Zimowski on HIV prevention issues including the prevention of mother-to-child transmission, protecting young people and reducing sexual violence against women and girls. “This will help accelerate the HIV prevention revolution, in promoting evidence-informed and human rights based approaches to achieve universal access goals towards HIV prevention, treatment, care and support,” said Mr Sidibé. “Together we can build a world with zero new HIV infections, zero discrimination and zero AIDS-related deaths.”

With more than 7000 new HIV infections each day, UNAIDS advocates the use of a combination HIV prevention approach that utilizes all proven methods for HIV prevention including use of male and female condoms, choosing to have sex later, having fewer multiple partners, male circumcision, reducing stigma and discrimination, and the removal of punitive laws. The male latex condom is the single, most efficient, available technology to reduce the sexual transmission of HIV and other sexually transmitted infections.

Decrease from US, offset by increased philanthropic giving from Europe, yields level response in time of AIDS funding crisis

Washington, D.C. and Brussels, 16 November 2010 – The European HIV/AIDS Funders Group (EFG), Funders Concerned About AIDS (FCAA), supported by the Joint United Nations Programme on HIV (UNAIDS), released new reports today on HIV/AIDS-related funding from US and European philanthropic donors. The reports show that while total funding decreased slightly (by 2%), most philanthropic donors increased commitments to the AIDS response in 2009.

HIV/AIDS-related funding from European and US philanthropic donors was USD 738 million in 2009, a slight decrease from USD 752 million the previous year. The findings are being released amidst a continued economic recession, flat or declining funding from governments, and a growing need for increased HIV prevention, treatment, care and support services.

Overall funding from European-based philanthropies increased significantly, reaching over €120 million (USD 152 million) in 2009, compared to €91 million in 2008. Expenditures increased by 25% in 2009 compared with 2008 among the same set of European HIV/AIDS funders, an unprecedented increase despite the current fiscal constraints.

The total given by US-based philanthropies decreased from USD 618 million in 2008 to USD 585 million in 2009, a reduction of 5% and the first decrease on record since FCAA began tracking disbursements in 2005. Funding from the Bill & Melinda Gates Foundation, which represented 57% of all US-based philanthropic HIV/AIDS-related funding in 2009, decreased to $334 million in 2009 from $378 million in 2008, while disbursements from all other funders increased from $237 million to $252 million (or 5%) from 2008 to 2009.

FCAA and EFG, joined by UNAIDS, commend the achievements of private donors who increased their support in 2009, but express concerns about any decrease in funding.

 “As the economy rebounds we hope that philanthropies will continue to expand their investments in the AIDS response,” said Paul De Lay, Deputy Executive Director, Programme, UNAIDS. “Investments on AIDS are starting to bear fruit as fewer people are becoming infected and with increased availability of treatment, fewer people are dying—evidence that AIDS is a smart and proven investment that will reduce costs in the long term.”

 According to a report released by UNAIDS and the Kaiser Family Foundation in July, donor government funding for HIV/AIDS, which represents a much larger share of global resources for HIV/AIDS than the philanthropic sector, was also essentially flat, decreasing from $7.7 billion in 2008 to $7.6 billion in 2009.

 “Because private funding represents a relatively small percentage of resources for HIV when compared with other larger public sources, philanthropy must exercise its unique advocacy and leadership roles in holding governments accountable, and leveraging public funds to provide an adequate response to HIV,” said John Barnes, Executive Director of FCAA.

 The rapid and unprecedented increase in financial support for HIV in previous years has saved and prolonged millions of lives, reversed years of declines in average life expectancy in many nations, and reinstilled hope in individuals and communities. Decreases in funding now could stop or reverse that hard-won progress.

 “Philanthropy can make a significant impact, especially in times like these,” said Astrid Bonfield, Chief Executive of The Diana, Princess of Wales Memorial Fund and EFG Chair. “Increased commitment, engagement, and financial support from private philanthropic donors can send a strong message about leadership and commitment in the fight against HIV.”

Other key findings include

• In both the US and Europe, HIV/AIDS-related philanthropic funding remained concentrated among a relatively small number of funders in 2009, with the top 10 funders (ranked by total expenditures) accounting for 83% of all HIV/AIDS-related expenditures in both regions.
• The majority of funding by both US and European-based philanthropies in 2009 was directed to addressing the epidemic outside of these regions (81% of all US and 65% of all European HIV/AIDS-related philanthropic expenditures).
• Projections by US-based funders for 2010 suggest that HIV/AIDS-related funding will decrease, with 33% of funders forecasting anticipated decreases for 2010, including the top funder, the Bill & Melinda Gates Foundation, which represented over half of all US philanthropic disbursements in 2009. Among European-based funders, projections suggest that HIV/AIDS-related philanthropy funding levels may increase, with 38% of funders forecasting anticipated increases for 2010, including six of the top ten funders. 

UNAIDS, FCAA and EFG emphasize that philanthropy has a critical role to play in the AIDS response on the basis of flexibility, ability to innovate and take risks, and political independence. The FCAA and EFG annual resource tracking reports intend to inform stakeholders about the overall distribution and trends of US and European HIV/AIDS philanthropic funding, to facilitate greater coordination and transparency among funders and encourage expanded philanthropic support for HIV work.

To download the complete reports:

• U.S. Philanthropic Support to Address HIV/AIDS in 2009 at www.fcaaids.org
• European Philanthropic Support to Address HIV/AIDS in 2009 at www.hivaidsfunders.org

About EFG

The European HIV/AIDS Funders Group (EFG) is a knowledge-based network dedicated to strengthening European philanthropy in the field of HIV/AIDS. The group aims to mobilise philanthropic leadership and resources to address the global HIV/AIDS pandemic and its social and economic consequences and to promote an enabling environment for strategic and independent giving in this field as well as fields closely connected to HIV/AIDS such human rights, global health, and global development. 

About FCAA 

Funders Concerned About AIDS (FCAA) was founded in 1987 with the goal of mobilizing the philanthropic leadership, ideas and resources of U.S.-based funders to eradicate the HIV/AIDS pandemic –domestically and internationally– and to address its social and economic consequences. FCAA is the only U.S.-based organization comprised of and for private philanthropic institutions concerned about, engaged in, or potentially active in the fight against HIV/AIDS.

About UNAIDS

UNAIDS, the Joint United Nations Program on HIV/AIDS, is an innovative United Nations partnership that leads and inspires the world in achieving universal access to HIV prevention, treatment, care and support. Learn more at unaids.org.

World leaders call on South-South cooperation to reverse the AIDS epidemic and lead an integrated approach to accelerate progress towards the Millennium Development Goals

NEW YORK, 22 September 2010—World leaders gathered at the United Nations called for a new model of partnership to strengthen the AIDS response and achieve broader health and development outcomes. Without synergy between AIDS and other health and development initiatives, the leaders agreed sustainable progress towards global goals to end poverty and ensuring healthy societies will not be achieved.

A high-level meeting co-hosted by China, South Africa, Nigeria, Ethiopia and UNAIDS brought together world leaders including the Premier of China, the Prime Minister of Ethiopia and Ministers from South Africa, Nigeria, Burundi, Democratic Republic of Congo, Kenya, and Rwanda. They were joined by heads of international organizations and civil society.

"The era of health and development programmes operating in isolation is over,” said Mr Michel Sidibé, UNAIDS Executive Director, who chaired the meeting. “We have to work together to make this one movement—we cannot afford to have a fragmented approach to health and development. This Africa-China partnership can be the engine that accelerates progress towards the MDGs.”

Developing countries are joining hands to push for a combined approach to health and development and giving communities a strong voice in defining their health needs. The new South-South partnership will promote innovation, local solutions that make a difference, sharing of technology, and building local capacities.

The AIDS epidemic is stabilizing globally and new infections are steadily declining around most of the world. This has been possible as the international community has made significant progress in achieving goals towards universal access to HIV prevention, treatment, care and support.

"We cannot turn a deaf ear to the call of life, and we must not be slow in reaching out,” said H.E. Wen Jiabao, Premier of China. “We should redouble our effort to advance the global campaign against HIV/AIDS and ensure that the related MDGs be met on schedule. China has been actively involved in the international cooperation on HIV/AIDS prevention and treatment."

Endorsing the UNAIDS approach of “AIDS plus MDGs”, the leaders called for the AIDS movement to take the lead in bringing about integration and innovation.

“The ‘AIDS plus MDGs’ approach seeks to bring about change that will create a new dimension of performance. Not just in the response to AIDS, but also in efforts to achieve other MDGs, accelerating progress on those that are trailing behind,” said Dr Asha-Rose Migiro, UN Deputy Secretary-General. “Progress towards reversing the HIV epidemic is therefore central to the broad international development agenda.”

Investments in AIDS have contributed to strengthening health systems and primary health care as well as better access to social welfare programmes in many countries. In Ethiopia, a strong, results-driven alliance between the Ethiopian Government and its key development partners is producing win-win results by channelling more than US$ 300 million of AIDS resources to strengthen the county’s health systems.

“Ethiopia’s strategy to integrate AIDS and health issues has not only decreased the burden on health facilities, but it has also enabled the health system to reach the vulnerable and poor,” said H.E. Meles Zenawi, Prime Minister of Ethiopia. “Community ownership of development has helped us achieve progress that is sustainable over time.”

South Africa has integrated HIV and TB services under one roof, reducing both AIDS and Tuberculosis-related deaths. Under its ambitious programme to test 15 million people for HIV, it is offering comprehensive health checkups for women and girls. In 2009, nearly 90% of all pregnant women were able to access treatment to protect their babies from being born with HIV.

“We have to strengthen primary health care services that integrate HIV, maternal and child health, sexual and reproductive health into development,” said Dr. Aaron Motsoaledi, Health Minister of South Africa. “Communities must own the health agenda which is at the centre of their own development.”

However, HIV continues to hamper progress in reducing maternal and child mortality in many sub-Saharan countries. More than 40% of all maternal mortality in countries such as Botswana (77%), Swaziland (75%), Lesotho (59%) and Zimbabwe (53%), Namibia (50%), South Africa (43%) is attributable to HIV.  Where health services are integrated, the results have been spectacular. In Pampaida, Nigeria, a Millennium Development Village in Kaduna state, there have been very few maternal deaths or children born with HIV in recent years, thanks to an integrated approach to health care delivery.

“We are saving mothers and children by strengthening the health system,” said Professor Onyebuchi Chukwu, Health Minister of Nigeria. “We are investing in health using resources from debt relief because access to good quality health care is a necessity and a basic human right, not a luxury.”

In 2000, world leaders adopted the Millennium Declaration. This milestone in international cooperation inspired development efforts that have improved the lives of hundreds of millions of people globally. Five years remain to move forward to meet the eight Millennium Development Goals by 2015.

New UNAIDS data show significant progress towards Millennium Development Goal 6: to halt and begin to reverse the spread of HIV by 2015.

GENEVA, 17 September 2010 — Ahead of the United Nations Summit on the Millennium Development Goals (MDGs) on 20-22 September 2010, UNAIDS today released data on progress towards MDG 6 and called for leveraging the AIDS response to support all MDGs.

The data shows that countries with the largest epidemics in Africa—Côte d’Ivoire, Ethiopia, Nigeria, South Africa, Zambia and Zimbabwe—are leading the drop in new HIV infections. Between 2001 and 2009, 22 countries in sub-Saharan Africa have seen a decline of more than 25% in new HIV infections. The number of new HIV infections is steadily falling or stabilising in most parts of the world.

“We are seeing real progress towards MDG 6,” said UNAIDS Executive Director Michel Sidibé. “For the first time change is happening at the heart of the epidemic. In places where HIV was stealing away dreams, we now have hope.”

However challenges remain. Eastern Europe and Central Asia continue to have expanding HIV epidemics, and in several high-income countries there has been a resurgence of HIV infections among men who have sex with men.

There are now 5.2 million people on HIV treatment, which is a 12-fold increase in six years. AIDS deaths have dropped significantly since the widespread availability of treatment—there were 200,000 fewer deaths in 2008 than in 2004. Young people are leading the prevention revolution by choosing to have sex later, having fewer multiple partners and using condoms, resulting in significantly fewer new HIV infections in many countries highly affected by AIDS.

Among adults, male condom use has doubled in the past five years. Tradition is giving space to pragmatism, as communities embrace male circumcision. Research has shown that male circumcision has the potential to reduce HIV infection among men by nearly 60%. New HIV prevention research reported efficacy in a microbicide controlled and initiated by women.

“To sustain the gains we are making, further investments in research and development are needed—not only for a small wealthy minority—but also focused to meet the needs of the majority,” Mr Sidibé said.

Many countries are showing good progress in the AIDS response. For example, in Asia, where the epidemic is concentrated among high-risk populations, China has scaled up access to harm reduction programmes for people who use drugs. Data from its national sentinel surveillance show that the percentage of drug users who used sterile injection equipment the last time they injected drugs increased from 40.5% in 2007 to 71.5% in 2009.

South Africa is rapidly accelerating efforts to achieve universal access to HIV prevention, treatment, care and support. New HIV infections among adults and young people have dropped by more than 25% and record numbers of women are accessing treatment to prevent mother-to-child transmission of HIV from previous years. The country has also significantly increased its domestic investments for the AIDS response in the current fiscal year. However in many low- and middle-income countries, the lack of resources is seriously hampering the scale up of programmes.

US $10 billion shortfall for the AIDS response

In 2009, an estimated US$ 15.9 billion was available for the global AIDS response, which is US$ 10 billion short of the estimated need. In 2009 international investments for AIDS were down from investments made in 2008.

“At this turning point flat-lining or reductions in investments will set-back the AIDS response and threaten the world’s ability to reach MDG 6,” said Mr Sidibé. “Investing for AIDS is a shared responsibility—between development partners and national governments.”

UNAIDS recommends national governments allocate between 0.5% and 3% of government revenue on HIV, depending on the HIV prevalence of the country. Domestic investments for AIDS have increased over the past decade, but for a majority of the countries severely affected by AIDS, domestic investments alone will not suffice to meet all their resource needs.

On the other hand, AIDS programmes can be made sustainable and affordable by increasing the efficiency and effectiveness of HIV programmes. This means knowing what to do and investing resources in the right direction—task shifting among health care workers, reducing unit costs, and focusing on effectiveness are all options that will help lower global resource needs in the long run. In addition, the resource availability must become predictable. Countries cannot respond effectively to the epidemic on a fiscal year basis.

Leveraging the AIDS response for all Millennium Development Goals

Current strategies for resource investments are failing the AIDS response. AIDS programmes must be taken out of isolation. By situating the AIDS response within the broader development agenda and integrating AIDS with other health, development and human rights efforts, the world can accelerate progress across the array of MDGs, optimize efficiency in the use of resources and save and improve more lives.

For example, new UN estimates show that there were 42,000 deaths due to HIV among pregnant women in 2008. About half of these deaths were estimated to be maternal.

“Integrating HIV investments for maternal health, sexual and reproductive health, as well as child health will leverage better results for millions of people most in need,” said Mr Sidibé. “As we move ahead, the HIV response can help accelerate progress across all eight development goals.”

UNAIDS will co-host the event AIDS plus MDGs along with China, Nigeria and South Africa on 22 September at the UN Summit. The aim is to look at ways of integrating the AIDS response with other health and development efforts.

“World leaders and UNAIDS are joining together to give the message that we must invest strategically to address multiple MDGs. Releasing the power, capacity and innovation of the AIDS movement may provide one of the best opportunities to ‘do the MDGs’ differently,” said Mr Sidibé.

The AIDS movement should be the bridge that connects other movements: maternal and child health, sexual and reproductive health, gender equality, sexual violence and the fight against women’s cancer.

GENEVA, 14 September 2010— The Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomes the UN Secretary-General’s announcement of the appointment of Ms Michelle Bachelet as head of UN Women, the United Nations Entity for Gender Equality and the Empowerment of Women.

The new entity, which was created in July 2010, has been established to provide a powerful voice for women and girls and will be instrumental in helping to achieve UNAIDS’ vision of zero discrimination, zero new HIV infections and zero AIDS-related deaths.

“Gender inequities, violence, lack of access to education, health and economic opportunities make women particularly vulnerable to HIV,” said UNAIDS Executive Director Michel Sidibé. “I look forward to working closely with Ms Bachelet to restore the dignity and rights of women all over the world and advance the response to HIV.”

Nearly half the people living with HIV in the world are women and AIDS is the leading cause of death in women of reproductive age worldwide.

Call for further trials needed to make promising antiretroviral gel available to women at risk of HIV as quickly as possible

GENEVA, 3 September 2010—Two further clinical trials are planned to confirm a vaginal gel which has shown potential in reducing the risk of HIV. The results of the first trial of the gel, which were announced in July at the XVIII International AIDS Conference in Vienna, must be confirmed before the product can be made available for general use.

The tenofovir-based gel was found to be 39% effective to reduce a woman's risk of becoming infected with HIV during sex in a study completed by the Centre for the AIDS Programme of Research in South Africa (CAPRISA), a UNAIDS Collaborating Centre on HIV prevention research.

The CAPRISA study was conducted in South Africa with women aged 18 to 40 years who used the gel once during the 12 hours before sex and once during the 12 hours after sex.

Experts at a meeting convened last week by UNAIDS and WHO in Johannesburg, South Africa, proposed that further trials should determine whether different populations of women will have the same level of protection as seen in the CAPRISA trial.

One study, which will take place primarily in South Africa, will establish if the CAPRISA results can be repeated in a variety of settings with a population that includes younger women. It will also evaluate whether the gel can be used safely by sexually active 16 and 17 year olds in settings where HIV incidence is high.

The other study, which will be conducted in other African countries, will examine if a different dosing schedule is safe and effective. It will test if a single application of the gel before sex, or failing that immediately after, is equally effective and safe as the original two dose regimen. The single dose schedule would be less expensive and easier for women to use.

In addition, an ongoing trial being conducted by the Microbicides Trial Network, studying the same gel but used daily, will generate additional data on safety and product use.

Research in the communities where the CAPRISA trial was carried out will also examine how to best promote, distribute, and monitor gel use through existing family planning facilities. This would allow former trial participants and others in their communities to have early access to the new gel, but within the context of programmatic research.

While participants agreed on research priorities, concerns were expressed over the limited funding committed thus far to carry forward the next phase of research, which is estimated to cost US$ 100 million. Only US$ 58 million is available.

Nearly 20 years of research have gone into microbicides. If confirmed, the tenofovir gel would empower women by adding significantly to the options they have to protect themselves from HIV without requiring the cooperation of their male partner. About half the people living with HIV in the world are women. In sub-Saharan Africa more women are infected than men. HIV is a major cause of maternal mortality.

“This promising tenofovir gel is a woman-initiated and controlled HIV prevention tool that could now be within reach,” said Dr. Catherine Hankins, Chief Scientific Adviser to UNAIDS. “Funders, advocates, and scientists can work together to close the funding gap rapidly, gather the evidence, and ensure that no time is lost in getting a safe and effective microbicide to women.”

Convened at the invitation of the South African government, the meeting brought together members of government agencies from South Africa and other countries, microbicide research teams and product developers, women’s health and HIV prevention advocates, people living with HIV, clinical and social science researchers, statisticians, civil society representatives, public health experts, ethicists, and representatives from national drug regulatory authorities.

  UNAIDS Executive Director, Mr Michel Sidibe (left) meeting the President of Burkina Faso, H. E. Blaise Compaore at the African Union Summit in Uganda, 27 July 2010.

Kampala, 27 July 2010 — Investing in the health of women and children was the focus of the high-level Summit of the African Union held 25-27 July in Kampala, Uganda. The meeting, attended by more than 35 Heads of State and politicians, highlighted progress and challenges in advancing Millennium Development Goals (MDGs) 4 and 5, which call for reducing child mortality and improving maternal health.

With only 11% of the world’s population, Africa accounts for more than half of all maternal and child deaths. Despite advancements in global health, the African continent has the world’s highest maternal mortality ratio and infant mortality rate. Progress towards MDGs 4 and 5 has been slow at best, hindered in many countries by a lack of financial resources for health and programme management.

“I strongly believe that a new movement is possible to prevent mothers from dying and babies from becoming infected with HIV,” said President Wade of Senegal, who introduced an agenda item on mother-to-child transmission of HIV at the Summit. “Progress in maternal and child health in Africa—indeed progress in the health of our populations in general—are hugely dependent on progress in the AIDS response.”

According to a recent study published in The Lancet, progress in reducing maternal mortality has been slowed by the ongoing HIV epidemic. According to the study, there were an estimated 343 000 maternal deaths in 2008. An additional 60 000 lives could be saved each year if women received appropriate HIV diagnosis and treatment, researchers reported.

  UNAIDS Executive Director, Mr Michel Sidibe (left) meeting the President of Namibia H.E. Hifikepunye Pohamba at the African Union Summit in Uganda, 27 July 2010.

UNAIDS Executive Director Michel Sidibé reminded meeting participants of the critical link between the AIDS response and maternal and child health. Globally, AIDS is the leading cause of death among women of reproductive age. In many countries on the African continent, AIDS is the leading cause of death among infants and young children. Each year, nearly 400 000 children in Africa are born with HIV. While in Kampala, Mr Sidibé reiterated his call for the virtual elimination of mother-to-child transmission of HIV as an achievable goal. He noted, however, that achieving an HIV-free generation—together with MDGs 4 and 5—will depend heavily on strengthened health systems.

“Mother-to-child transmission of HIV has been virtually eliminated in the global North. It is unacceptable that so many babies continue to be born with HIV in Africa,” said Mr Sidibé. Countries such as Botswana have already reached universal access targets for the prevention of mother-to-child transmission of HIV. Many other countries are close behind.

Mr Sidibé was joined at the Summit by Prof. Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, who urged African leaders to mobilize more resources for the AIDS response. “The Global Fund has so far invested more that USD 11 billion in Africa helping countries to reduce maternal and child mortality through targeted interventions addressing AIDS, TB and malaria which are still major killers of African women and children. This support should increase further to meet even better the needs of countries,” said Prof. Kazatchkine.

The lives of mothers and their babies can be saved through a combination of HIV testing and counseling, access to effective antiretroviral prophylaxis and treatment, safer delivery practices, family planning or the safe use of breast-milk substitute. The recent announcement at the XVIII International AIDS Conference that a vaginal gel containing the antiretroviral drug tenofovir had been successfully tested opens a potential new avenue for HIV prevention among women.

22 July 2010 - Vienna, Austria - It's a story that unfolds every day around the world but is rarely heard. A woman, man or child living with HIV gets exposed to tuberculosis (TB) in a setting where there are no measures to stop the spread of infection. It could be a workplace, a prison, a clinic or even at home. Soon the person is sick - coughing, feverish and weak.

This story is being told and retold this week among the 20 000 participants gathered for the 2010 International AIDS Conference. It's a story that can end well if the person is lucky enough to have access to both antiretroviral and TB treatment. But too often there is a fatal finish. Without proper treatment about nine out of 10 people living with HIV who become ill with active TB will die within two to three months.

The dual epidemic has fanned across Africa, Asia and Eastern Europe and affects women, men and children from every walk of life. One in four deaths among people with HIV is linked to TB - that's about half a million people who die unnecessarily each year.

"Every three minutes a person living with HIV has his or her life cut off prematurely by TB. This is completely unacceptable, because TB is a preventable and curable disease," said Dr Jorge Sampaio, the United Nations Secretary-General's Special Envoy to Stop TB.

Global public health leaders gathered at this conference have committed to an ambitious new agenda to stop these preventable deaths. Dr Sampaio presided today over the signing of a landmark document: a memorandum of understanding between the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Stop TB Partnership. The agreement binds the two organizations together in a common goal: to strive towards halving the number of people living with HIV who die from TB by 2015, compared to 2004 levels. Provision of life-saving antiretroviral treatment for all TB patients living with HIV is another key objective.

“We already have the tools to keep people living with HIV from dying of TB ”, said Mr Michel Sidibé, Executive Director of UNAIDS, ”We must join our TB partners to promote an evidence and human rights based approach to tackling TB and HIV. Together we can virtually eliminate TB related AIDS deaths.”

Stop TB and UNAIDS will press government health programmes to reach all people in need of care for TB/HIV by integrating the services that provide diagnosis and treatment for both conditions; and also seek to increase the resources needed to accomplish this goal. Another overarching objective is to galvanize civil society organizations, communities affected by TB and HIV and the private sector to form strong partnerships aimed at jointly addressing TB/HIV.

In keeping with the focus of this year's AIDS conference, the signers stressed the needs of marginalized groups. "We call on the world's leaders to promote full access to HIV and TB services for women and girls, orphans, displaced persons, migrants, prisoners, men who have sex with men, people who use drugs other vulnerable groups," said Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership.

During 2010 and 2011 the leadership of Stop TB and UNAIDS will make at least two joint visits to countries heavily affected by TB/HIV per year and promote their new initiative at least one international event per year.

GENEVA, 21 July 2010 — The Joint United Nations Programme on HIV/AIDS (UNAIDS) launched today a new UNAIDS High Level Commission on HIV Prevention, which includes more than 15 world renowned leaders. Commissioners will use their unique authority and influence to lead a social and political action campaign over the coming year aimed at galvanizing support for effective HIV prevention programmes.

The Commission is co-chaired by Professor Francoise Barré-Sinoussi, Nobel Laureate in Medicine for her role in the discovery of HIV, and Archbishop Emeritus Desmond Tutu, Nobel Peace Price Laureate.

“Today, for every 2 persons starting treatment, 5 new infections occur,” said Professor Barré-Sinoussi. "The growing curb of the epidemics cannot be stopped without a strong and global commitment to combined HIV prevention measures, including treatment."

Archbishop Tutu said, "The only way to be cured of HIV is not to be infected. For the sake of the future, and for the sake of those currently living with HIV, we must take the path to zero new HIV infections."

“We have received amazing leadership support for the UNAIDS High Level Commission on HIV Prevention,” said UNAIDS Executive Director Michel Sidibé. “The greatest successes in the AIDS response have been achieved in countries where the leadership has mobilized and made reducing new HIV infections a top priority. With the backing of these celebrated personalities, we can bring about a prevention revolution and reverse the AIDS epidemic.”

The members of the Commission are:

• Dr Michelle Bachelet, Former President of Chile;
• Mr Jacques Chirac, Former President of France;
• Ms Vuyiseka Dubula, Secretary-General of the Treatment Action Campaign;
• Dr Mohamed ElBaradei, Nobel Peace Prize Laureate; 
• Ms Elena Franchuk, Ukrainian businesswoman and founder of the Elena Franchuk ANTIAIDS Foundation;
• Mr Pau Gasol, Spanish professional basketball star; 
• Mr Nizan Guanaes, leading Brazilian communications entrepreneur, Chairman of Grupo ABC de Comunicação;
• Mr Chris Hughes, Executive Director of Jumo, International, co-founder of Facebook;
• Mr Magic Johnson, Former basketball star and one of the first sports celebrities to declare his HIV-positive status;
• Ms Irene Khan, Human rights activist and former Secretary-General of Amnesty International;
• Mr Robin Li, Entrepreneur and co-founder of China’s most popular independent search engine, Baidu, Inc.;
• Ms Rita Süssmuth, former President of the German Federal Parliament and former Federal Minister for Family Affairs, Women, Youth and Health;
• H.E. Festus Mogae, Former President of Botswana;
• H.E. Jean Ping, Chairman of the African Union;
• Professor Peter Piot, Former Executive Director of UNAIDS and incoming Director of the London School of Hygiene and Tropical Medicine;
• Mr Vladimir Vladimirovich Pozner, celebrated Russian journalist;
• Mr Mechai Viravaidya, Thai politician and activist, famous for popularising condoms in Thailand.

A Scientific Advisory Panel chaired by Ms Laurie Garrett of the Council on Foreign Relations will assist the High Level Commission by using state-of-the-art scientific research to develop a road-map incorporating the best strategies in HIV prevention.

“We will look at what works in HIV prevention, drawing attention to country level successes and elaborating actions needed to overcome current failures and deficiencies," said Ms Garrett.

Thirty years into the AIDS epidemic, the world has made unprecedented progress in the treatment of people living with HIV. But over 7,000 new HIV infections occur every day.  While treatment has grabbed the limelight as a key strategy in the AIDS response, prevention has often been neglected. The Commissioners will take the message of a recommitment to HIV prevention to their circles of influence, swaying public opinion to support the implementation of effective HIV prevention programmes.